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EFTA00792171
) 83c Account number Date Amount .00 Third-party designee? (see Instr.) Yesird No ri EmS: • Paid preparer must complete/ Mane. 51010.1r. DAVID WEI SS Print designee's name DAVID WEI Designee's phone number may NYIPRIN Personal identification number (PIN) 13349 /metope. 03 Preparers prow n
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